Healthcare Provider Details

I. General information

NPI: 1346463536
Provider Name (Legal Business Name): SCHAUMBURG INTERVENTIONS & COUNSELING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1340 REMINGTON RD SUITE K
SCHAUMBURG IL
60173-4830
US

IV. Provider business mailing address

1340 REMINGTON RD SUITE K
SCHAUMBURG IL
60173-4830
US

V. Phone/Fax

Practice location:
  • Phone: 847-882-8908
  • Fax: 847-882-8996
Mailing address:
  • Phone: 847-882-8908
  • Fax: 847-882-8996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number
License Number State

VIII. Authorized Official

Name: DR. FE A VELASCO
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 847-882-8908